Active NPI
Pro-Step Rehabilitation
- Physical Therapy Assistant
- Mount Vernon, IN
National Provider Identifier
1003013095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06003430A
- Legal business name
- PRO-STEP REHABILITATION
- Practice address
- 1415 Country Club Rd
Mount Vernon, IN 47620-9301 - Phone
- (812) 838-6554
- NPI assigned
- Jul 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Jessica Ann McDonald, PTA
- Title
- Physical Therapist Assistant
- Phone
- (618) 924-0404
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06003430A | IN | Primary |
| Physical Therapy Assistant | 225200000X | IL |
Addresses
Primary practice location
1415 Country Club Rd
Mount Vernon, IN 47620-9301
Mailing address
105 Meadow Hills Dr
MC Leansboro, IL 62859-1212
Phone (618) 924-0404
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1184112000000",
"number": "1003013095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MEADOW HILLS DR",
"city": "MC LEANSBORO",
"state": "IL",
"postal_code": "628591212",
"telephone_number": "618-924-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 COUNTRY CLUB RD",
"city": "MOUNT VERNON",
"state": "IN",
"postal_code": "476209301",
"telephone_number": "812-838-6554"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRO-STEP REHABILITATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-11",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "JESSICA",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "PHYSICAL THERAPIST ASSISTANT",
"authorized_official_telephone_number": "618-924-0404",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "PTA"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06003430A",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.